CPT 17260 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 76 - Repeat procedure by same physician |
| Complexity Level | Low |
National average reimbursement for CPT 17260 by major payers:
$113.96
$121.13
$125.31
$160.86
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 17260 | ||||||
United | 17260 | $566.00 | 1255577045 - MAPLE LAWN SURGERY CENTER | 262739529 - (MD) MAPLE LAWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $105.00 | 1821397654 - RENUE SURGERY CENTER OF WAYCROSS, LLC | 273847480 - (GA) RENUE SURGERY CENTER OF WAYCROSS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $166.19 | 1336142728 - MOHAMMED ALLAW | 350593390 - DEACONESS HOSPITAL INC | IN | Internal Medicine Physician (207R00000X) |
United | 17260 | $328.00 | 1043746555 - OVERLAND PARK SURGICAL SUITES, LLC | 814367607 - (KS) OVERLAND PARK SURGICAL SUITES LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $341.00 | 1043612534 - HHC ASC, LLC | 824195385 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $566.00 | 1346693124 - VILLAGES ENDOSCOPY CENTER LLC | 813250494 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $166.19 | 1124466040 - NATHAN OAKLEY | 350593390 - DEACONESS HOSPITAL INC | IN | Family Medicine Physician (207Q00000X) |
United | 17260 | $102.00 | 1497084982 - WAKE ENDOSCOPY CENTER, LLC | 208232362 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $111.00 | 1801890173 - NOVAMED SURGERY CENTER OF CHATTANOOGA LLC | 270039586 - (TN) NOVAMED SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $688.00 | 1932258415 - GLENDALE ENDOSCOPY CENTER, LLC | 202837412 - (CA) GLENDALE ENDOSCOPY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $345.00 | 1427078930 - RETINA CONSULTANTS SURGERY CENTER | 223314785 - (NJ) RETINA CONSULTANTS SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $566.00 | 1396342481 - PIEDMONT ASC LLC | 851448653 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $546.00 | 1346289428 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE SURGEONS SEATTLE ORTHOPEDIC CENTER-ASC | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $90.00 | 1639386659 - MIDWEST EYE CONSULTANTS, P.C., CLI SURGERY CENTER | 351845786 - (IN) MIDWEST EYE CONSULTANTS, P.C. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17260 | $385.00 | 1992941462 - NORTHWEST ENDOSCOPY CENTER, LLC, NORTH WEST ENDOSCOPY CENTER | 364644974 - (GA) NORTHWEST ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 17260 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 17260 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 17260 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 17260-CPT | Low | Destruction, Malignant Lesion (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms Or Legs; Lesion Diameter 0.5 Cm Or Less |
| 17261-CPT | Low | Destruction, Malignant Lesion (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms Or Legs; Lesion Diameter 0.6 To 1.0 Cm |
| 17262-CPT | Low | Destruction, Malignant Lesion (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms Or Legs; Lesion Diameter 1.1 To 2.0 Cm |
| 17263-CPT | Moderate | Destruction, Malignant Lesion (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms Or Legs; Lesion Diameter 2.1 To 3.0 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 17260. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 17260 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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